Arepally Aravind
The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutes, Baltimore, MD 21287, USA.
J Magn Reson Imaging. 2008 Feb;27(2):292-8. doi: 10.1002/jmri.21266.
The main goal of local drug delivery is to increase the concentration of a specific therapeutic agent in a target tissue with minimal nontarget distribution. Compared to systemic therapy, local drug delivery provides a high level of therapeutic efficacy with minimal systemic effects. The current primary imaging modality for drug delivery has been x-ray angiography, but it has major limitations including anatomical ambiguity and inability to visualize the targeted tissues. Due to these inherent problems, MR guidance has been explored as an alternative imaging modality for guiding and monitoring of drug therapy. Recently, interventional MR (XMR) systems have been implemented that have both dual x-ray and MRI capabilities in a single suite and allow for real-time interventional procedures to be performed in a clinical setting. In cases where drug delivery is required, this system provides a significant leap for catheter-based therapies. Although clinical drug delivery procedures utilizing MR guidance are still in the early stages of development and application, recent technological advances should help further promote the adoption of such procedures. This review covers the emerging techniques of drug delivery using MR guidance.
局部给药的主要目标是在目标组织中提高特定治疗剂的浓度,同时使非靶组织分布最小化。与全身治疗相比,局部给药以最小的全身效应提供了高水平的治疗效果。目前用于给药的主要成像方式是X射线血管造影,但它有主要局限性,包括解剖结构不清晰以及无法可视化靶组织。由于这些固有问题,磁共振引导已被探索作为指导和监测药物治疗的替代成像方式。最近,已经实现了介入式磁共振(XMR)系统,该系统在单个设备中同时具备双X射线和磁共振成像能力,并允许在临床环境中进行实时介入操作。在需要给药的情况下,该系统为基于导管的治疗带来了重大飞跃。尽管利用磁共振引导的临床给药程序仍处于开发和应用的早期阶段,但最近的技术进步应有助于进一步推广此类程序的采用。本综述涵盖了使用磁共振引导的新兴给药技术。